Abstinence Shouldn’t be the Only Outcome Measure for Addiction Recovery

Successful recovery from drug and alcohol addiction through attending a residential treatment program means more to the person than just staying clean and sober, an Australian-first study has found.

Successful recovery from drug and alcohol addiction is multi pronged and multi faceted

While a significant body of research has shown that the length of time a person stays in a program is positively linked to abstinence, reduced crime, better employment prospects and improved quality of life, much of the work has focused on achieving and maintaining abstinence as the main measure of a program’s success.

No qualitative research in Australia has understood what successful recovery means from the client’s point of view

And to date no qualitative research in Australia has moved beyond those indicators to understand what successful recovery means from the client’s point of view.

Therapeutic communities are drug-free residential rehabilitation programs where clients live together in a supportive environment over a period of months, with increasing levels of social and personal responsibility supported by counselling, personal change and skills training used to rehabilitate drug and alcohol users.

Low completion rates of residential drug and alcohol treatment programs a major challenge

Low completion rates of residential drug and alcohol treatment programs are a major challenge in establishing effective and sustainable rehabilitation programs.

A study of former residents of the Buttery, a community-based residential rehabilitation program on the NSW north coast, found that successful drug and alcohol treatment takes a wider view to include their feelings of self-worth and their ability to contribute to society through employment, study or volunteering.

Tarran Prangley, a medical student from Graduate Medicine at the University of Wollongong, interviewed a number of ex-residents of the Buttery to understand the reasons people entered rehabilitation programs in the first place, which could shed light on why they might withdraw early.

“Former residents spoke about the need for a ‘circuit breaker’ in their life. They were struggling with childhood trauma and experienced ongoing poor mental health, or they were in trouble with the law.

“The suffering associated with hitting rock bottom is a strong motivator to do something about addiction, to reassess their life and seek help and some see attending a program as their last chance in life.”

The study, a collaboration through the University Centre for Rural Health, Lismore, between the University of Wollongong School of Medicine, Western Sydney University School of Medicine, and the Buttery, revealed the residents’ idea of success involved their sense of overall self-worth, from how the program helped improve relationships, their psychological and physical well-being, understanding of addiction and putting them on the track to gaining employment, studying and volunteering.

Many of the study participants withdrew from the program early

While many of the study participants withdrew from the program early, Ms Prangley said many of them were still experiencing positive outcomes, which indicated the program was successful, even if it wasn’t completed.

“Some of the reasons residents left early were not surprising. Nine months away from the world can be quite isolating from friends and family and for some people the programs themselves can be intense, but others left because they felt they’d learned enough about how to manage their addictions and could go back to their normal lives.

“And one or two people experience lapses, they said they were able to recognize the signs early and stop themselves relapsing completely.

“In that sense the program should still be considered successful and validates the approach, but the exit surveys and other data doesn’t collect that information.”

Study’s results could indicate a shift in the way people view recovery

Dr Sabrina Pit from Western Sydney University said the study’s results could indicate a shift in the way people view recovery, away from being defined solely by abstinence towards a more holistic view.

“From a policy and treatment point of view this shows the value of supporting residents to not only focus on abstinence but also to identify how they can actively contribute to the community, through studying, volunteering or finding employment.”

“Some people have returned to volunteer in rehabilitation programs and this can be a powerful way to show those in the program they can be successful in their recovery too.”

Trent Rees, Residential Programs Manager at the Buttery, said the research was a validation of the approach and reinforced the need to change how successful recovery is defined.

“One of the great things the study highlighted was that even when people leave early and they say they don’t understand why we took certain approaches or why they felt the program was hard for them, many of those in the research indicated they understand now, they get it, and that takes time.

“When people come to programs like ours they may have also tried other interventions.

“Rather than see that as a series of failures, we need to recognize that recovery is a journey and all the steps taken along the way contribute to their long-term well-being and recovery.”

With crime, road accidents, lost productivity and healthcare costs from substance abuse disorders costing the economy and healthcare system around $55 billion annually, Mr Rees said the cost of residential rehabilitation paled in comparison.

“An independent review that evaluates the efficacy of programs is necessary to justify funding them in the first place and to demonstrate their value in helping people become active contributors to society again.”

The study was funded by a generous donation in memory of the Late John Shaw Warnock.

Razi Berry is the founder and publisher of the journal Naturopathic Doctor News & Review that has been in print since 2005 and the premier consumer-faced website of naturopathic medicine, NaturalPath. She is the host of The Natural Cancer Prevention Summit and The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10 week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and Chronic Fatigue Syndrome and Fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. Follow Razi on Facebook at Razi Berry and join us at Love is Medicine to explore the convergence of love and health.

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